Chapter 1 Respiration Flashcards
Respiration
the exchange of gas between an organism and its environment.
provides air supply needed to set the vocal folds into vibration for speech, Speech is typically produced during exhalation. Expiration in about 60% of the normal tidal breathing cycled inspiration is the remaining 40%. This ratio changes to 90% and 10% when breathing for speech.
Inhalation and Exhalation
create the rhythmic cycle of of respiration
Process of Inhalation
inhalation-chest and lungs expand- diaphragm lowers- air flows in through the nose and mouth- air goes down the pharynx and between the open vocal folds- air continues downward through the trachea and bronchial tubes- air reaches final destination of the lungs
This cycle continues 12-18 times per minute in adults
Structures of respiration
lungs, bronchi, trachea, spinal column, sternum, and rib cage
Trachea
a tube about 11 centimeters long formed by approximately 20 rings of cartilage. The rings are incomplete in the back where the the trachea comes into direct contact with the esophagus. The first cartilage is larger than the rest and connects to the inferior (bottom) border of the cricoid cartilage.
The trachea extends from the larynx at the level of the 6th cervical vertebra and the last tracheal ring splits in two BIFURCATES, the left and right primary bronchi
Spinal Column
Consists of 32-33 individual vertebrae, divided into 5 segments
7 cervical vertebrae C1-C7
12 thoracic T1-T12
5 lumbar L1-L5
5 sacral-S1-S5, fused in adults
3-4 coccygeal vertebrae, fused and called the coccyx
Cervical Vertebrae
small and in the neck
Thoracic Vertebrae
provide points of attachment for the ribs
Lumbar Vertebrae
largest of the spinal column, which makes them suitable for weight bearing functions
Sacral vertebrae
fused together forming the sacrum
Coccyx
formed by fused coccygeal vertebrae, often called the tailbone
Sternum
“breastbone” is located in the superior, anterior thoracic wall. Consists of 3 parts: manubrium, body, and diploid process
Manubrium
uppermost portion of the sternum. Provides the attachment for the clavicle and the first rib
Corpus or Body
long and narrow, The cartilages of ribs 2-7 attach here
Xiphoid Process
small cartilaginous structure found at the bottom of the body of the sternum
Rib Cage
the chest, consists of 12 pairs of ribs that articulate posteriorly with the vertebral column. Have a degree of mobility which allows the rib cage to elevate during inhalation. Houses and protects the heart and lungs.
Consists of the sternum in the anterior surface, 12 thoracic vertebrae in the posterior surface, and 12 pairs of ribs that connect laterally from the vertebrae to their individual costal cartilages.
Thoracic Muscles of Inspiration
diaphragm, abdomen, intercostal muscles, external intercostals, serrates posterior superior, levator costarum brevis, levator costarum longis, and external intercostal
Diaphragm
the floor of the chest cavity, thick domed shaped muscle that separates the abdomen from the thorax. The lungs rest upon stand because of this it plays a major role in breathing and is considered the primary muscle of inspiration.
Distends abdomen, enlarges vertical dimension of thorax, depresses central tendon of diaphragm
Serratus Posterior Superior
elevates rib cage
Levator Posterior Superior
elevates rib cage
Levator Costarum Brevis
Elevates rib cage
External Intercostal
elevates rib cage
Sternocleidomastoid
accessory muscle, elevates the sternum and indirectly, the rib cage. They are attached to the first 2 ribs and indirectly enlarge the vertical dimension of the thorax
trapezius
accessory muscle, controls the head and elongates the neck, They are attached to the first 2 ribs and indirectly enlarge the vertical dimension of the thorax
scalenes
accessory muscle, anterior, middle, and posterior, stabilize and rotate the head. They are attached to the first 2 ribs and indirectly enlarge the vertical dimension of the thorax
Shoulder Muscles
pectorals major, pectorals minor, serratus anterior and levator scapulae
Pectoralis Major
C4-T1, Increases transverse dimension of the rib cage through elevation of the sternum
Pectoralis Minor
C4- T1 increases transverse dimension of rib cage
Serratus Anterior
C5-C7, elevates ribs 1-9
Levator Scapulae
C3- C5 elevates scapula, supports neck
Rhomboideus Major
C5, stabilize shoulder girdle
Rhomboideus Minor
C5, stabilizes shoulder girdle
Internal Intercostal
T2-T11, Depresses ribs 1-11
Innermost Intercostal
T2-T11, depresses ribs 1-11
Transverse Thoracis
T2-T6, depresses ribs 2-6
Subcostal Muscle
posterior thoracic muscles that support exhalation, depresses the thorax
Serratus Posterior Inferior Muscles
posterior thoracic muscles involved in exhalation, when contracted, pull the rib cage down
Abdominal Muscles of respiration
latissimus dorsi, rectus abdominis, transverse abdominis, internal oblique abdominal, and quadratus lumborum
Latissimus Dorsi
C6-C8, stabilizes posterior abdominal wall for expiration
Rectus Abdominis
T7-T12, flexes vertebral column
Transverse Abdominis
T7-T12, compresses abdomen
Internal oblique abdominis
T7-T12, compresses abdomen, flexes and rotates trunk
Quadratus lumborum
T12, L1-L4, supports abdominal compression through bilateral contraction which fixes abdominal walls
Larynx
AKA “voice box” lies at the top of the trachea and houses the vocal folds, it is a valving mechanism that opens and closes, Structures of the larynx include: epiglottis, hyoid bone, thyroid cartilage, cricoid cartilage, and tracheal ring.
biological functions include: closure of the trachea so food does not enter the lungs, production of the cough reflex to expel foreign substances that enter the trachea, and closure of the vocal folds to build sub glottal pressure necessary for physical tasks such as excretion and lifting heavy items.
Vocal folds
vibrate to produce sounds, they adduct and abduct as they vibrate
Adduct
move toward the midline
Abduct
move away from the midline, when a person is breathing quietly the vocal folds are abducted
Hyoid Bone
floats under the mandible (lower jaw) The muscles of the tongue and various muscles of the mandible, skull, and larynx attach here.
epiglottis
protective structure, leaf shaped piece of cartilage medial to the thyroid cartilage and hyoid bone. During swallowing the epiglottis drops to cover the orifice of the larynx
Key cartilages of the larynx
cricoid, thyroid, and arytenoid
Thyroid Cartilage
largest laryngeal cartilage and forms the anterior and lateral walls of the larynx. Composed of two laminae/plates, that meet in the midline to form the THYROID ANGLE
Open posteriorly and has 2 pairs of horns, Cornu.
Thyroid Notch
Adams Apple, superior point of the thyroid angle
Superior Cornua
extends upward to meet the hyoid bone,
Inferior Cornua
extends downward to meet with the cricoid cartilage
Cricoid Cartilage
uppermost tracheal ring, linked with the thyroid cartilage and the paired arytenoid cartilages. Completely surrounds the trachea and is larger in the back than in the front
Arytenoid Cartilage
small. pyramid shaped cartilages connected to the superior posterior cricoid through the cricoarytenoid joint which permits sliding and circular movements. Many intrinsic laryngeal muscles connect to the arytenoid cartilages at 2 processes: vocal process and the muscular process
vocal process
location where the focal folds are attached to the arytenoids
Muscular Process
muscles that both abduct and adduct the vocal folds, place of attachment to the arytenoids
Corniculate Cartilages
small, cone shaped. Sit on the apex of the arytenoids. Assist in reducing the laryngeal opening when a person is swallowing.
Cuneiform Cartilages
located under the mucous membrane that covers the aryepiglottic folds. Serve to stiffen or tense the aryepiglottic folds.
Intrinsic Laryngeal muscles
primarily responsible for controlling sound production. These muscles include: thyroarenoid, lateral cricoarytenoid, transverse arytenoid, oblique arytenoid, cricothyroid, and posterior cricoarytenoid
thyroarytenoid muscles (X)
paired muscles, each is attached to the thyroid and arytenoid cartilages and is divided into 2 muscle masses, the internal thyroarytenoid and the external thyroarytenoid
primary portion of the thyroarytenoid muscle, which vibrates and produces sound
Internal thyroarytenoid
the primary portion of the thyroarytenoid muscle, which vibrates and produces sound. Also referred to as “vocalis muscle” or “vocal folds”
External thyroarytenoid
also know as the “thyromuscularis muscle” is lateral to the vocalis muscle and when contracted aids in vocal fold adduction
Adductor Muscles
includes: lateral cricoarytenoid, transverse arytenoid, and oblique arytenoid.These muscles act to bring the vocal folds together. The lateral cricoarytenoid increases medial compression of the vocal folds by rotating the arytenoids medially.
Cricothyroid Muscle
attached to the cricoid and thyroid cartilages. It lengthens and tenses the vocal folds, resulting in pitch change
Lateral Cricoarytenoid (X)
adducts vocal folds, increases medial compression
Transverse Arytenoid (X)
adducts vocal folds
Oblique Arytenoid (X)
pulls apex of the arytenoids in a medial direction
Cricothyroid (X)
lengthens and tenses vocal folds
Posterior Cricoarytenoid (X)
abducts vocal folds
Glottis
a small opening that forms when the vocal folds are abducted. It is not an anatomical structure, it is merely the name of that opened space between the vocal folds
Extrinsic laryngeal muscles
supports the larynx and fixes its position
have 1 attachment to a structure within the larynx and one attachment to a structure outside the larynx. All are attached to the hyoid bone and lower or raise the the position of the larynx with in the neck
Suprahyoid Muscles/Elevators
attach above the hyoid bone, primary function is elevation of the larynx
consists of the digastric, geniohyoid, mylohyoid, stylohyoid, hyoglossus, and genioglossus.
Infrahyoid Muscles/Depressors
attach below the hyoid, primary function is depression of the larynx
Consists of the thyrohyoid, omothyroid, sternothyroid, and sternohyoid
Vocal Folds
3 layers: epithelium or outer cover, lamina propria or middle layer (which has 3 layers itself), and vocals muscle or body which provides stability and mass to the vocal fold
Aryepiglottic folds
composed of a ring of connective tissue and muscle extending from the tips of the arytenoids to the epiglottis. They separate the larygeneal vestibule from the pharynx to help preserve the airway
Ventricular or False folds
vibrate only at very low fundamental frequencies and usually not during normal or typical phonation. Compress during such activities as coughing and lifting heavy items
Myoelastic-Aerodynamic Theory and Bernoulli Effect
states the vocal folds vibrate because of the forces and pressure of air and the elasticity of the vocal folds
- The air flowing out of the lungs is temporarily stopped by the closed or nearly closed vocal folds. This builds up sub glottal air pressure which eventually blows the vocal folds apart. During this process the folds are set into vibration as well.
- the air then moves with increased velocity through the glottal opening. As the air moves swiftly through the open but still somewhat constricted, vocal folds, the pressure between the edges of the vocal folds decreases and consequently the folds are sucked together.
- The BERNOULLI Effect occurs when the velocity of a gas of fluid increases when it passes through a constriction, decreasing the pressure of the gas or fluid. In this case the BE is caused by the increased speed of air passing between the vocal folds (the constriction) The resulting decrease in pressure between the vocal folds causes the sucking motion of the vocal folds toward one another.
- once again sub glottal air pressure builds up and sets the folds in motion creating the cycle of opening and closing the vocal folds. This cycle is repeated more than 100 times per second during vocalization. Frequency depends on their length, tension, and mass per individual
Mucosal Wave
critical to vibration of the vocal folds, the cover (epithelium and superficial lamina propria, AKA Reinke’s space) and the transition (intermediate and deep layers of the lamina propria) over the vocalis muscle slide and produce a wave
- this wave travels across the superior surface of the vocal fold about 2/3 of the way to the lateral edge of the fold. Generally the wave dissipates before reaching the inner surface of the thyroid cartilage. Without a mucosal wave there is no vibration and thus no phonation.
- Vocal folds that have been stripped surgically to remove such abnormal vocal growths as nodules may be stiff and vibrate inefficiently due to alteration of the normal mucosal wave.
Cortical Areas
Primary cortical areas involved in speech-motor control, including phonation include:
1. Area 4- primary motor cortex
2. Area 44- Broca’s area
3. Areas 3, 1, and 2- somatosensory cortex
4. Area 6- supplementary motor cortex
Cerebellum
regulates motor movement, critical in the control of speech movement.
the key to the coordination of the laryngeal muscles for adequate phonation and effective functioning of other speech systems such as respiration.
Cranial Nerves
VII- the facial nerve, innervates the posterior belly of the digastric muscle
X- vagus nerve, includes the following primary branches, which innervate the larynx.
Superior laryngeal Nerve (SLN)
internal and external branches, the internal branch receives all sensory information from the larynx and the external branch supplies motor innervation solely to the cricothyroid muscle.
Recurrent laryngeal nerve (RLN)
supplies all motor innervation to the iternerary-tenoid, posterior cricoarytenoid, thyroarytenoid, and lateral cricoarytenoid muscles. It receives all sensory information below the vocal folds
